Comprehensive review and update of cytomegalovirus infection in pregnancy TOG 2016

Question 1

What is the most common congenital viral infection

Answer 1

Cytomegalovirus
Prevalence at birth 0.5%

Question 2

What proportion are seropositive during pregnancy?

Answer 2

40-60%

Question 3

CMV is the leading cause of which condition?

Answer 3

Sensorineural deafness
12% hearting loss in UK
8% cerebral palsy

Question 4

Risk of vertical transmission if primary infection?

Answer 4

40%
More likely to have severe complications if infection occurs in 1st/early 2nd trimester
More common to become infection in 3rd but has minimal sequlae

Question 5

Risk of vertical transmission if recurrent CMV

Answer 5

1-2%

Question 6

What proportion of SMV are symptomatic at birth?

Answer 6

90% asymptomatic
10% have signs of birth, high risk long term neurological sequelae
Further 10% become symptomatic

Question 7

What proportion of symptomatic babies will die?

Answer 7

30% - DIC/hepatic dysfunction or bacterial infection

Question 8

CMV immunoglobulin cross reacts with which other condtion

Answer 8

Parvovirus
Ebstein barr
Lupus

Question 9

When does avidity become high

Answer 9

About 12-16 weeks after infection

Question 10

Sensitivity of USS detecting CMV?

Answer 10

20%

Question 11

When should amniocentesis be performed

Answer 11

> 7 weeks after presumed time of maternal infection and after 21 weasek

Question 12

Flow diagram for prenatal Dx of congenital CMV

Answer 12